All cancers are staged according to definitions established by the AJCC (American Joint Committee on Cancer 2002). Staging a cancer, generally from stage I to IV allows the physician to better select appropriate treatment.
Prostate cancer is initially staged by a digital exam. The digital exam provides feedback to allow the doctor to assess the extent of disease in the gland. For patients who udergoing surgery, the pathology report helps to 'pathologically' stage the disease.
Tumor staging:
T1: Clinically inapparent tumor neither palpable nor visable by imaging T1a: Tumor incidental in less than 5% of resected tissue. T1b: Tumor incidental in more than 5% of tissue resected. T1c: Tumor identified by needle biopsy (e.g., because of elevated PSA)
T2: Tumor confined within the prostate T2a: Tumor involves 1/2 of one lobe or less T2b: Tumor involves more than 1/2 of one lobe but not both lobes T2c Tumor involves both lobes
T3: Tumor extends through the prostate capsule T3a: Extracapsular extension (unilateral or bilateral) T3b: Tumor invades seminal vesicle(s)
T4: Tumor is fixed or invades adjacent structures other than seminal vesicles; bladder neck, external sphinter, rectum, levator muscles, and or pelvic wall
Clinical prostate cancer in 2004:
The majority of men diagnosed with prostate cancer have T1c or T2a tumors, or localized cancer, that are confined to the prostate gland. When tumors are beyond the capsule of the prostate (T3 and T4), they are considered locally advanced.
Treatment decisions are based on the tumor extent and staging.
